Hepatocellular carcinoma metastasis to the mandible: a challenging diagnosis

Introduction: Metastasis of hepatocellular carcinoma (HCC) to the mandible is an extre-mely rare condition with less than a hundred cases reported worldwide. Such lesions do not have any pathognomonic clinical, radiologic, or histologic features, and they can mimic many other conditions or diseases with orofacial involvement. Case report: We present an interesting but intriguing case of metastasis of HCC to the mandible, which presented as an orofacial swelling accompanied by intense pain and spontaneous bleeding following tooth removal. Conclusion: This paper highlights the importance of integration of the in-depth medical history of the patient, clinical findings, and microscopic examinations in cases of uncommon oral lesions of challenging diagnosis. (AU)

Endoscopic features in a model of multivisceral xenotransplantation.

INTRODUCTION: Xenotransplantation and multivisceral transplantation are advanced therapeutic methods that still require a scientific basis. There are no experimental models of multivisceral transplantation available, particularly not the monitoring by endoscopy. Here, we describe the endoscopic features in a model of multivisceral xenotransplantation. METHODS: The distal esophagus, stomach, intestine, colon, liver, pancreas, and the kidneys with a common vascular pedicle were harvested from rabbits and implanted in swine (group I, n = 9) or in rabbits (group II, n = 4). Endoscopy was performed in the stomach, jejunum, and ascending colon at four consecutive time points (immediate after surgery and 10, 90, and 180 min after reperfusion). Lesions were macroscopically graded as mild, moderate, and severe. Biopsies were taken following sacrifice at 180 min after reperfusion. RESULTS: In group I, the stomach, jejunum, and colon manifested a progression of lesions with predominance of mild lesions after 10 min, mild to moderate lesions after 90 min, and moderate to severe lesions after 180 min. In animals from group II, endoscopy showed normal features at all time points after reperfusion. Histopathologic analysis confirmed the diagnosis of hyperacute rejection in group I. Grafts from group II animals presented normal or mild ischemic/reperfusion injury. CONCLUSION: All animals subjected to multivisceral xenotransplantation showed a progression of endoscopic lesions with time after transplantation, while animals subjected to allotransplantation showed no aberrations in endoscopy. We conclude that endoscopy is a useful tool in the assessment of hyperacute rejection of a xenograft.